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HomeMy WebLinkAbout0052 COVENTRY LANE i l . NO. 1521/3 ORA MADE IN USA ESSE`TE 4, f f ,. c � � i { i. e 4 C I /F 4 C F i 1 4 i t' tt r Application number. ............................................ .....v............................ Fee ............... .................:......................................... • s. sm U. ' ocr Building Inspectors Initials.. . . . ............. �� 01018 bnA ���) ���NU� Date Issued.......I•�,13!.�•►s..................................... �'11 SMBLE Map/Parcel....... . .................l .l ..... ................ TOWN OF BARNSTABLE EXPEDITED PERMIT APPLICATION: ROOF/SIDING/WINDO W S/DOORS/TENTS/STOVES/WEATHERIZATION PROPERTY INFORMATION Address of Project: NUN TREET VILLAGE Owner's Name: 1�(�,UtIER V I d - Phone Number t.M° /71S Email Address: COKI'O 1 �� Cell Phone Number Project cost $ 10 4q 4 - Check one Residential Commercial OWNER'S AUTHORIZATION As owner of the above property I hereby authorize to make application for a building permit in accordance with 780 CMR Owner Signature: Date: TYPE OF WORK 0 Siding 0 Windows (no header change) # 0 Insulation/Weatherization 0 Doors (no header change) # Commercial Doors require an inspector's review Roof(not applying more than I layer K;q,-ZL s) Construction Debris will be going to CONTRACTOR'S INFORMATION Contractor's name Dal aw (/'�DVLGh Home Improvement Contractors Registration(if applicable) # )70 V (attach copy) Construction Supervisor's License# b Z 00 (attach copy) Email of Contractor M CC @ moo. COA Phone number W'360-Z?Yf ALL PROPERTIES THAT HAVE STRUCTURES OVER 75 YEARS OLD OR IF THE SUBJECT PROPERTY IS IN A HISTORIC DISTRICT, YOU MUST OBTAIN HISTORIC APPROVAL BEFORE A PERMIT CAN BE ISSUED. APPLICATION NUMBER ......................................................... *For Tents Only* Date Tent (s) will be erected Removed on number of tents total Does the tent have sides? Yes No (If yes please attach floor plan with exits marked) Dimensions of each Tent X , % X X ` Additional tent dimensions can be attached on a separate piece of paper. Purpose of Event Check one: this event is a: for profit non-profit event Check one: Food served Yes No Flame Spread Sheet of each tent must be attached. Provide a site plan with the location(s) of each tent Fuel source being used LP tank 20 lbs. or> Yes No , if yes, a gas permit is required. Natural Gas Yes No , if yes, a gas permit is required. If food is being served at your event please obtain a Health Department approval between the hours of 8:00am-9:30 am or 3:30 pm-4:30pm. Commercial events may require Fire Department approval. *WOOD/COAL/PELLET STOVES Manufacturer# Model/I.D. Fuel Type Testing Lab Offsets from combustibles: front back left side right side HOMEOWNER'S LICENSE EXEMPTION Homeowner's Name: Telephone Number Cell or Work number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures, specific inspections and documentation required by 780 CMR and the Town of Barnstable. Signature Date APPLICANT'S SIGNATURE Signature Date c0 3b All permit applications are subject to a building official's approval prior to issuance. IMPORTANT: Y the eeAtflicatp holder is an ADDITI NAL INSURED,the paicypes(must be erdursed. E SUBROGATION IS WAIVED,subject to the terms and conditions of the policy,ceriain pdieles may retire an endorsement A statement on this eertificate does notconfer rlqhtsto the certiftcateholder in Iteu of suchendorseener►tfCO"s. R ; ;! Anne Samo HUB INTERNATIONAL NEW ENGLAND LLC = sos 945-M3 �+ra 6' _ :tr17Tr3 s oett 2W ORLEANS RD rrs ARORSD%CYOOVE*PIAZE s NORTH CHATHAM to 02650 wasmaAe AKIGUARDINSURANCECO 42320 9MEFEDisr Eea.: ---------------------------.Y._._.- ----------------_..__._....... - ROOFING&SIDING OF CARE COD LLC vgg3wac R ersrrsFa;tf 68 WINStOW GRAY ROAD WEST YARMOUTH MA O2673 COVEPAGES CEFITIFICATE NUtnBEM:226618 REVISION NUMBS . THS 6 TOCERTFY TWIT THE,PM1CJES OF N1,WPAMM LSTEDSE10W KNVESUM I TED TO THE @tSLRED X1AMDASOVE FOR DIEP0.iCY'PERM MICATED. NOTMITASTAXONG ANY REOtA MMIT,TERM OR COMT M OF ANY CONTRACT®R 07MR OOCf LMff WNW:RESPECT TOWMCt1 TM CERT7 LATE MAY BE tSSL ED OR UAY IPERTA lk THE INSURAME AFFDRDED BY THE:POLUES DES RiEWD HEREIN I'SUBJECT TO ALL THEE TERMS, EXCLUSiOW AND GdA[MttsOFSUCwP0uCiES_Ti}JjrssHmv%,LMHAVE.BEENRE LACEDBYPAMCAIMS, S KXJCT rims ?CIiJCYfA? COYrsAdTJ 11GENElAMA8LOT EAWIJI CA6 TSQ:, 5 �y{ SdSYE#' An.zeae, 5 CE:M ACKF"cCAT£iAMAPAAES {1111# CEWFaW-AGUMEM.ATEFnp b Pa—cY� ntCi� F JCTS-C40WMPA93 5 OrKit S. CtMM)sSM&Et9mB'P g. _... :. ANVALM OLaiIP KJUN iPar¢+necnT S AU SOHEOMM urmWMDAUMS ._. 0t7fli.P'YfiJ1TN of a'a'ufi¢Nt 5 MVDVWM T..rrLYS f ff a �Ef06:EF6 LidB ; 'Mo RETE0.`TtC:Ir 6 5 YJnt l6'CESLF:fffi90IR .a/fTkCA' F `� 'P<P: flit-€. 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CANCELLATION) SHDIIDAUYOPTNEABMEiDESGMED POLMUM DECANCEI I HGWE THE EXPIRATM DATE THEiEM, NOME WLL DE OEUM ED IN.. Roofing &Siding of Cape Cod LLC AC6t�1ffi1NCECitt1H7NEPOtICYPFlOVC9C� 53#N'r,s�flwGraq.Ro-ad wtrrx� Tn� West Yam MA 02673 `* ` D Li .V CPCILVk*Pcssiten.-I;es Markei-%VCRBM 0 t91iffi2014 ACORDCORpoRAnom. Al tights reserved; ACORD25(20t4" The ACDRD name and lop are registered marks of ACORD t The Commonwealth of Massachusetts ' Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information Please Print Legibly Name(Business/Organization/Individual): RSOcc Address: C ���5� PP City/State/Zip: Phone#: ,Z 7y. Are you an employer?Check the appropria a box: Type of project(required): 1.� I am a employer with 4. ❑ I am a general contractor and I employees(full and/or part-time). * have hived the sub-contractors 6. ❑New construction 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g• ❑Demolition workingfor me in an capacity. employees and have workers' � Y P h'• x 9. ❑Building addition [No workers' comp.insurance comp.insurance. required.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.❑ I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself. [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. iContractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. I am an employer that isproviding workers'compensation insurance for my employees. Below is thepolicy and job site information. � Insurance Company Name: p� [ j Policy#or Self-ins.Lic.#: RUC 0 ��y Expiration Date: l Z ?t P Job Site Address: 52 W Vz✓) I City/State/Zip: Attach a copy of the workers' compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify the ains and penalties of perjury that the information provided above is true and correct. Si ature: ��/ Dat 3D Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: r. Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152, §25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e. a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston, MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Fax#617-727-7749 Revised 4-24-07 www.mass.gov/dia C � --- .---- _ _� C� �.! f ' i �� I Roofing and Siding of Cape Cod,LLC ,.r BBB. 68 Winslow Gray Rd West Yarmouth, MA 02673 508-360-2749 a-mail: rsocc@vahoo.com roofingandsidingofcapecod.co m HIC REG #170787; LIC # 102600 NameDAVID VANGELDER Job Address: Address: 52 COVENTRY LN Town: City: W.BARNSTABLE Job Phone: 508-916-1718 State: MA Other Phone: n ZIP: E-mail: ffA1S(f017/0 ( Estimator: SCOTT DICKSON 06/09/18 We hereby submit specifications and estimates to furnish and install new roofing as follows: 1. Strip existing roofing and remove debris. Calculated(1 layer).Anymore layers of roofing needed to be stripped will be additional. 2. All gutters will be cleaned out, grounds cleaned up and nails extracted with magnets. We utilize magnets so as to minimize your exposure to personal injure and/or property damage from nails left behind at the job site. 3. After removal of roof,wood deck will be inspected for splitting,rot or other deterioration. Owner will be advised of need for wood replacement prior to commencement of wood replacement work. 4. Along all eaves of house. Ice & Water Shield waterproofing underlayment (36 " wide) will be directly adhered to the wood deck. Waterproofing underlayment is installed to eaves to protect against interior leakage and subsequent damage from wind-driven rain, ice and snow dams, and freeze back conditions. 5. Install waterproofing underlayment in full width(36 wide)to all valleys and 12"to all rake edges. Install waterproofing underlayment at all vent pipe collars and any other projections and skylights.Underlayment adds additional protection against leakage at critical terminations. Over remainder of house synthetic roofing paper will be installed and nailed to the wood deck. 6. Install new white drip edge to all perimeter cave edges. Drip edge is installed to protect from leakage and rot and to provide a neat and clean perimeter profile. 7. All existing vent pipes will receive new aluminum vent pipe flashings with neoprene gasket collars, or copper if doing red cedar roof. 8. At all eave edges or roof, shingle starter strip will be cut an installed with sealing strip at lower edge of roof in accordance with manufacturer's specifications. This provides a watertight and wind-resistant termination for your roof. 9. Storm nailing: Because we live in a severe storm region, additional (storm) nailing is strongly recommended by Roofing and Siding of Cape Cod, LLC, the manufacturers and the National Roofing Contractors Association. Secure new roof with 50% more nailing, upgrade minimum standard(4)four nails per shingle to(6)six nails per shingle, 1 '/4 " long.Nails will be galvanized with a rust-inhibitive coating. If red cedar roof,then using stainless steel fasteners. 10.Shingle installation: Supply and install roofing shingles according to the manufacturer's specifications, according to the below selected material and warranty. All work to be performed by insured professionals. 11.Install waterproofing underlayment surrounding chimney. Underlayment will extend up vertical portion of chimney a minimum of (2) two inches. Caulk all lead flashings together around chimney with Dymonic caulk. This is not a guarantee but a maintenance procedure. We cannot guarantee chimney from leakage with roof job only. See chimney proposal if applicable. We cannot guarantee existing skylights or venting units unless we replace them with new ones. 12.At peak of roof, an approximate (3)three-inch-wide continuous gap will be cut out of deck. Air Vent, Inc. Shinglevent II solid vinyl ridge vent with external baffle will be fastened over the opening in the deck. Shingle caps will be cut, installed and fastened over the vinyl ridge vent into the decking with 2 %2 inch coated roof nails. Shinglevent II comes with a 30-year material warranty from Air Vent, Inc. Shinglevent II vinyl ridge vent provides you home with the necessary exhaust ventilation to prolong the life of the shingles and the wood sheathing to ensure a properly balanced ventilation system if used in conjunction with eave intake ventilation, and provide cooler attic temperatures in the summer and less moisture-laden damaging air in the winter. The above s specifications are required to meet the National Roofing Contractors Association (NRCA) roof standards, as well as to meet manufacturer's specifications for warranty requirements. Touch-up painting may be required and is not included in this proposal. Roofing and Siding of Cape Cod, LLC warranty: products and workmanship (100% Labor and Materials) for 10 (ten) Years after installations. Roofing and Siding of Cape Cod,LLC will obtain necessary,permits required by the Town. CertainTeed warrants that its shingles will be free from manufacturing defects. Below are highlights of the warranty for LandmarkTM. See CertainTeed's Asphalt Shingle Products Limited Warranty document for specific warranty details regarding this product. • Lifetime, limited transferable warranty • 10-year SureStartTM warranty(100%replacement and labor costs due to manufacturing defects) • 10-year StreakFighterTM warranty against streaking and discoloration caused by airborne algae • 15-year, 130mph wind-resistance warranty GOOD:Landmark, with Life-Time Warranty II Labor and Materials: $9200.00 If acceptable, initial here Color BETTER: Landmark-PRO, with Life-Time Warranty Labor and Materials: $9775.00 PROS COME WITH A 20YR LABOR AND MATERIAL NON PRORATED I WARRANTY THIS IS A$500.00 VALUE AT NO ADDED COST TO YOU If acceptable, initial here Color BEST: Landmark-PREMIUM, with Life-Time Warranty Labor and Materials: $10925.00 y PREMIUM COMM WITH A 50YR LABOR AND MATERIAL NON PRORATED WARRANTY THIS IS A $1000.00 VALUE AT NO ADDED COST TO YOU If acceptable, initial here Color 111 41r lwaD ee ezx�f I ' Ventilation System Ventilation is a system of intake and exhaust that creates a flow of air. Effective attic ventilation provides year-round benefits, creating cooler attic in the summer and drier attic in the winter,protecting against damage to materials and structure, helping to reduce energy consumption and helping to prevent ice dams. EAVE VENTING: Perimeter eave venting will provide your house with the necessary intake ventilation to prolong the life of the shingles and the wood sheathing to ensure properly balanced ventilation system in compliance with FHA requirements and to provide cooler attic temperatures in the summer and less moisture laden damaging in the winter. Vented Dripedge If acceptable, initial here Job is estimated to commence approximately_4_weeks after deposit received unless otherwise noted here: Work is scheduled to be substantially completed in approximately: days If acceptable,(both)initial here: Start and completion times are approximate and subject to change due to,but not limited to,the following circumstances: weather delays, additional work on previous jobs,permitting delays, etc. This is the entire agreement. Any discussions or verbal agreements are superseded by this agreement. Such agreements, even those of the smallest nature, must be in writing to be recognized. Any work above and beyond the specifications outlined in this proposal will be priced on request. All additional work, including travel time and lumberyard runs,will be subject to extra charge. In the event of rot repairs, roof repairs or any related work requiring immediate attention, we will proceed without customer approval. We look forward to working with you;please call if you have any questions. Sincerely, ROOFING AND SIDING OF CAPE COD,LLC ROOFING AND SIDING OF CAPE COD,LLC will provide cleanup on a continuing basis and all debris will be removed from site. All products installed by ROOFING AND SIDING OF CAPE COD, LLC will be to manufacturer specifications. All work will be performed by insured professionals. All material is guaranteed to be as specified and the above work to be performed in accordance with the drawings and/or specifications submitted for above work and completed in a substantial workmanlike manner. There will be no refund for special-order windows, doors or any other non-stocked materials after three days from approved proposal. All warranties will be null and void if account is not current and paid in full. Owner to move all personal objects, furniture, etc., from work areas. All items against walls should be considered for removal during any exterior siding jobs, additions, etc. to guard against damage. In the case of any roofing and ridge venting, dust and debris should be expected and any items in the attic should be removed.ROOFING AND SIDING OF CAPE COD,LLC is not responsible for any damages if said items remain in place. Curtains, drapes and window and door treatments may need proper reinstallation or replacement by customer due to sizing on any window or door replacements and is not included in jobs contracted with ROOFING AND SIDING OF CAPE COD, LLC Any alteration or deviation from above specifications involving extra costs will be executed only upon written orders and will become an extra charge over and above the estimate. All agreements contingent upon strikes, accidents or delays beyond our control. Owner to carry fire, tornado and other necessary insurance upon above work. Workmen's Compensation and Public Liability Insurance on above work to be taken out by ROOFING AND SIDING OF CAPE COD, LLC. Owners who secure their own construction-related permits or deal with unregistered contractors will be excluded from access to the guaranty fund. This Contract not valid unless signed by Corporate Officer: i Acceptance of Estimate The above prices, specifications and conditions are satisfactory and are hereby accepted. ROOFING AND SIDING OF CAPE COD,LLC is authorized to do the work as specified. Payment will be made as such: 1/3 Deposit c 1/3 Beginning of work—6V 1/3 upon completion 3u� Date: /DZ� Signatures. Note:No work shall begin prior to the signing of the contract and transmittal to the owner of a copy of such contract. You, the buyer may cancel this transaction at any time prior to midnight of the third business day after the day of this transaction. 1 � �e epcYmmaa�zrue¢l� �C�/�n�dc�ccdefle —i I Office of Consumer Affairs oa Businesccs Regulation HOME IMPROVEMENT CONTRACTOR Registration r TYPE:LLC I stration valid for Individual use only before the expiration date. If found return to: Registration Expiration 170787 12/18/2019 Office of Consumer Affairs and Business Regulation 10 Park Plaza-Suite 5170 ROOFING AND SIDING OF CAPE COD,LLC. Boston,MA 02116 D7_MITRY LP,BKOVI.CH �� i 68WINSLOW GRAYRD W.YARMOUTFI,MA 02673 j . Not valid•witho t signature, Undersecretary 6L0z/[Z/£0 0lssltuLuO3 :u0l1ejidx:g t £[9z,Qi VW H1f10Wav k 1S3m AV110 MOISNIM 89 i} H0IA0)I8V1 J H.LIWZ0 JoslAJadnS uol;anj}suoO 009ZOL-so :asuaol-I sp�epue;S Pue suol;eln6aa 6ulpl!�(;ajeS n8 do pjeo8 ollgnd 10luaLuPedap s4asn4oesseW / • i � Town of Barnstable "Wilding e ���� +Post This Card So.That it is Visible From the Street-Approved Plans Must be Retained on-Job and this Card Must!b e Kept 1639. P v M" Posted Until Finallnspection Has Been Made. _ ermit Fob° Where a Certificate of Occupancy is Required,'such^Building shall.Notbe Occupied until a Final Inspection has been made. Permit No. B-18-2687 Applicant Name: LAYNE,JOYCE Ap provals Date Issued: 10/10/2018 Current Use: Structure Permit Type: Building-Addition/Alteration-Residential Expiration Date: 04/10/2019 Foundation: Location: 52 COVENTRY LANE,WEST BARNSTABLE Map/Lot: 110-004-006 Zoning District: RF Sheathing: Owner on Record: LAYNE,JOYCE Contractor Name. Framing: 1 Address: 6 JULIA GRACE LANE Contractor License: 2 HARWICH, MA 02645 Est.Project Cost: $ 18,000.00 Chimney: . Description: 36'shed dormer roof addition to expand kitchen and replace Permit Fee: $ 141.80 Insulation: existing sun deck Fee Paid: $ 141.80 Project Review Req: Date: 10/10/2018 Final: Plumbing/Gas Rough Plumbing: Building Official Final Plumbing: Rough Gas: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months after issuance. All work authorized by this permit shall conform to the'approved application and the approved construction documents for which this permit has been granted. Final Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the work until the completion of the same. Electrical Service: The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on.this permit. Minimum of Five Call Inspections Required for All Construction Work: Rough: 1.Foundation or Footing ' 2.Sheathing Inspection Final: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Low Voltage Rough: 5.Prior to Covering Structural Members(Frame Inspection) 6.Insulation Low Voltage Final: 7.Final Inspection before Occupancy Health Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Final: Work shall not proceed until the Inspector has approved the various stages of construction. "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Fire Department Final: Building plans are to be available on site All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT t , C711(a G �lS �! � 0 Applic�onN=bcr...........B.— . .L.A...—..-2�r 7.......... r r r t r 3iAe8. Pcrniid Fee......�.... ..i.. ..................Other Fee.................:...... Total Fee Paid..................................................................... 10 TOWN OF BARNSTABLE Al Pm=&Approval by... .. .. .. ...............on. + Q.'�F v rv►v vr- _bAHNS ;gBLE - BUILDING PERMIT MV....J_...........................parcel...... D00 ... APPLICATION Section I — Owner's Information and Project Location Project Address-&o? CaedjMe Al Village 41 Owners Name /. /// u•�'+J C����� Owners Legal Address r City �r� / /STf�%c� State Zip Owners Cell# E-mail .✓ �G = —' Section 2—Use of Stractare Use Grroup r{ ❑ Commercial Structure over 35,000 cubic feet ❑ ' Commercial Structure under 35,000 cubic feet Single%Two Family Dwelling Section 3—Type of Permit ❑ New Construction ❑ Move/Relocate ❑ Accessory Structure ❑ Change of use ❑ Demo/(entire structure) ❑ Finish Basement ❑ Family/Amnesty ❑ Fire Alarm Rebuild Deck Apartment ❑ Sprinkler System Addition ❑ Retaining wall ❑ Solar ❑ Renovation ❑ Pool ❑ Insulation Other—Specify Section 4-Work Description P � 1 P T sgct rmdsmr&2/9/201 S Application Number.........................:.......................... Section 5—Detail Cost of Proposed Construction Square Footage of Project ' Age of Structure ,/�93 Dig Safe Number #Of Bedrooms Existing Total#Of Bedrooms(proposed) 3 110 MPH Wind Zone Compliance Method ❑ MA Checklist ❑ WFCM Checklist Design , Section 6—Project Specifics ❑ Wiring ❑ Oil Tank Storage ❑ Smoke Detectors ❑ Plumbing ❑ Gas ❑ Fire Suppression ❑ Heating System ❑ Masonry Chimney ❑Add/relocate bedroom Water Supply ❑ Public Private Sewage Disposal ❑ Municipal [ On Site Historic District ❑ Hyannis Historic District Old Kings Highway Debris Disposal Facility: /.) io I an using a crane ❑ Yes No Section 7—Flood Zone Flood Zone Designation Within or adjacent to a wetland,coastal bank? Yes ❑ No Section 8—Zoning Information Zoning District Proposed Use Lot Area Sq.Ft. Total Frontage Percentage of Lot Coverage #of Dwelling Units (on site) Setbacks Front Yard Required Proposed Rear Yard Required Proposed Side Yard Required Proposed Has this property had relief from the Zoning Board in the past? ❑ Yes No Lz&=awa nt2018 Application Number........................................... j., Section 9—.Construction Supervisor Name Telephone Number Address City State Tap License Number License Type Expiration Date Contractors Email Cell# I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedin es,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your license. signature Date Section-10—Home Improvement Contractor Name Telephone Number Address City State Zip Registration Number Expiration Date I understand my responsibilities under the rules and regulations for Home Improvement Contractors in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 CMR and the Town of Barnstable.Attach a copy of your H.I.C... Signature Date Section 11—Home Owners License Exemption Home Owners Name: -22j/b Telephone Number \-OLF- 916 l7l0 Cell or Work Number I understand my responsibilities under the rules and regulations for Licensed Construction Supervisor in accordance with 780 CMR the Massachusetts State Building Code. I understand the construction inspection procedures,specific inspections and documentation required by 780 and the Town of Bamstable. Signaitae Date MVUClA�T- IGNATURE Signatur Date Y/lP/� Print Name �JTelephone Numbers E-mail permit to: — de Ur)lu gELddSSC T e..4....,.i,w-a.n mnnj o Section 12 Department Sign-Offs 4Y' Health Department ® Zoning Board(if required) ❑ Historic District ❑ Site Plan Review(if required ❑ I Fire Department ❑ Conservation For commercial work,please take your plans directly to the fire department for approval Section 13—Owner's Authorization I as Owner of the-subject property hereby j authorize to act on my behalf in all matters relative to work authorized by this building permit application for: (Address of job) Signature of Owner date Print Name Last wasted:2192019 :j i cn gov m °- D e3^o if WEla IIDa� ogo - o 0 _nuo•' �3on o:�on 01 m $g IN ^x�� aS a.��n A �° S °'S �` g � \ggf °ao3o8g3d -n.5 r ;8S g 3 3°Qo go6a �W gem.: ag �� ss o'gm o ° Wig* °70 €EP €sbt�io e� 8'-e's a as_s w ppp a o3�c $n a °$ - 'Non o CR - _•3 ,g i G HUM� � amm Nmg� mpm $� on9�Nomo i•ii�� ��� _ 20 C I S c op ql c �c jai ci g iz onm $m xF �z F z- Z m�on��° n1� om$ o �m onm_ 'zn Ao E °zi �--I a° vS8 $ opop � 2io L nz �zs 5 �zo �� g m Co m_ '2 -' �PAC� �o om;� 'o nm � : cO' 1�1� �M. N2Fv;i S noll mo �o F p Mm eAp€ > AN wow NF yzN,rnN� ozN o F o1�' Figm - m V. CAO O OOm.m Sn m Aim 's8 ta: v A s r�i m w C�c F^NS m qb-P nm � 03 A IZ-� m � $ Pia _ iN nm p 6`•�<< 2; �L z"=-'o o m 2 `J n mOL A O G A� vi m� O p L o _• _ a $A Foz m � _ CJ - IRS gi m qm�� a do Q A Z I =� tm o00o vpo�n %0 l tnp Vn FA F nmLn �y ny Gi 3 N � •9 N� ➢�'�C � yA90 O�� tV ryry Nino r'yo §yi noA-i11p ca a gp L, d C �L �>yOZ� ZOSOC ,y,1Z A OSZ Fip F-� 'sL-S'm: �z@� 6Rg O<� yu'O� �90 OsS 11A�112 N`2,�1°N m 8N gg � £ C211 �In Glym < 2-SI A 6 e o�mA AC �3�? Epp m0� I9NA OF LA Z 2° n0 CNN A O OZ 89 g-2Y1 U. �� X.l'�' Lfi n 1��nI ff�n1 ZAN O G� 2 U1 =OR CQm A.oB �O R 110 O vv-1I l]LN ZR O aR HUH y m O 2� O 0 O�AO��mAONOmIZ,I 2 �N �~F �c Nam FCP@@ME@ O@ � yoc E b' cmiimm O RLp AU ggpz°oi26 omo Tm�oozi2a�oL d o m m M l.' nL n AO zg 02F N�� rpi ��� of sy ��yym((O o> p; 2;; ��� OLI TN; 5�imm$NP ga h� �yAZ >Zy2 34 pmO ng� OAm2<�Nz RE IMP O Np yo� V D tt$SS �1.�2 nBO1m.I Gl2 �'Z sA ;p A r� Na my1> N2SLym� Oi p O_ Zmn n� 2 ?o OAf � Ci C ffG fD 'C3 a cou, �b ~ "9 cXN) 'fCR. 51.1a'� DATE: 10/4/18 ADDITION TO BACK OF HOME R IS THE INTENT OF THESE DOCUMENTS TO DWG. NO. _ J 0 H N S P I N K P,Fj E. PROVIDE SUFFICIENT INFORMATION TO THE SCALE: 1/4"-1' KRISTIN COHAN f EXPERIENCED BUILDER TO CONSTRUCT THE PROJECT SHOWN. IT IS THEREFORE HIS DAVID VAN GELDER DESIGNS RESPONSIBILITY TO VERIFY ACCURACY AND COMPLIANCE WITH ALL REGULATORY AGENCIES WIND BRACING 52 COVENTRY LANE 59 CLAY STREET, MIDDLEBORO, MA 02346 PRIOR TO CONSTRUCTION. THEIR REOUIRE- WEST BARNSTAB LE, MA PHONE 774-766-0544 MENTS MUST TAKE PRECEDENCE OVER THOSE SHOWN, AND FIELD ADJUSTMENTS MADE 0 co° c ACCORDINGLY. _ Fix_ _ _ - �_ � kk _�u� F�(-fl�� ri �I rl k� ,��I I.L&F L-rF r-. -I- n _ L w k; a ts;, i I -- �, � a CD Fl go , CD • ri i ' J o — ----_—"-- -_ �' ' I -t° ' 3 m h ir V7 r n LIT— .... .r 77 4 ti t -f N •p i - I r r ' • Z L Oq . 7 - I ' r e - r �- Z ` - s .. / zt A 'I: { � •r � u t*) { 3 i5 i F I i i sag 'I Jeck1 A)'�w d�flTcdN • 12."SnNo`r�17ES ;I t C26a �0 r R slin, i d- An a,v elf , i; I aoi i Ili}N i i It a �� nvE�772v Lai 4,]�I O 1 fO/C AbMi 6 a�¢ Pis' 6 ' 1f4 ,o T l�0S£ 7� c.� L_g _. 6-B a - `° cr Barnstable Bldg.bept. Approved by Permit #: _ is _ .............. .......... r 0 3 � � 16 Qua CU�MD�• I 2 y Sys R A z nee Sll� n., A O � p a A � f�,R,' mitts a � � o Lv Y ^ •L ' 1 , 1 n c 1 _ A BUILDING Or-* i S EP1s2918 D E C E � V E TOWN OF BARNS TABOU AUG 2 12018 Town of Barnstable,Planning&Development Department a Old Ding's Highway Historic District COmmi eq�LANNING& DEVELOPMENT NAM 200 Main Street,Hyannis,Massachusetts 02601 Phone 508.862.4787 Email erin.loganntown:barnstable.ma.us CERTIFICATE OF EXEMPTION Application is hereby made,with four.(4)complete sets,for the.issuance of a Certificate of Exemption under Section 6 and 7 of Chapter 470,Acts and Resolves of Massachusetts,1973,as amended,for proposed work as described below and on plans,drawings,or photographs accompanying this application: Date Address of Proposed work, Assessor's Map and lot 0®vQQ�, House# Street —a,,6�d�'"s ' This application is for an exemption of the proposed construction on the grounds that work: Will not be visible from any way or public place ❑ Is within a category declared exempt by the Old Kings Highway.Regional Historic District Commission ❑ Other llescription of Proposed Work: �� J�CY�/ 1 o ✓fC its Agent or contractor(please print): Tel.no. Address Owner(please print): B t/) aaA , Z� � Tel no. jO Owners mailing address: J� �i/� 73, 1 _! 6� Signed,Owner/Contractor/Agent Checklist U Four complete sets of the application and supporting documentation 0 $ Filing Fee(see attached schedule) For Committee Use Only This Certificate is hereby APPROVED/DENIED Date: Committee Members Signatures: PROVE® SEP 12 2018_ Town of Barnstable Conditions of approval: Old King's Highway Committee OKU Exemption Form 2017 • OF PROPERTY . r . r r MAPS- j,, i _ Legend Y �...- 1 rqp 1 os•. .,f • S `'� - n Parcels Town Boundary #160 ,'1 �� `: #2 5 / /^ r q! / Railroad Tracks .. #U9© lam` "`, ''�� j'`f' , r f'� tt ,r175 Buildings ;# 49� �V :• `� �� #.209 �`" ti f / f/• s� 10 Approx.Building _r-r' �, •`. +` �a In Buildings K = r� -- ~ f� I•' / Painted Lines too ~..� I #5 Parking Lots Paved 1 !r \t;:2+.\. 'y' t�•`• ,.��/ ;, t':j--"+,_-�. r *#174 _ Unpaved Cf� )r ` `�— Driveways 11. ''t � ,•l, #183 �`� f r �.5 �, �� r_`1�'�S "+y„ �-`� l� 0 Paved # 1; 4 �` 5 "�` ^y ff, f� �' 'S` .s '.•�_•�-dsl.' _:Unpaved : . f Y: Roads Paved Road �i Unpaved Road 1 #1.63 �, .. 1` rf//yf • - •" 0 Bridge ;..\ f• ~� I ■Paved Median till #173y� `� r / #r4o t tt' ""' ""'111 Streams Marsh Q �..., i ,r t •' ��t: f:.� � Water Bodies 179 f -',�-. -��f � f�: ,, �' I �'- . ., r .sty-� . �` •'`y #26 r �'� �`., �' f !f f f+ - .rl.: •,; a.:- =#t34•t; _ , - r 'f #194 1 -..-� y •` 'J 1 #10 -. A. 7 10 # 97E ............. ..... Map printed on: 8/22/2018 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA 026ol 0 167 333 an on-the-ground survey.It maybe generalized,may not accurate relationships to physical objects on the map 5o8-862-4624 reflect current conditions,and may contain such as building locations. Approx.Scale: 1 inch= 167 feet cartographic errors or omissions. gis@town.barnstable.ma.us i l' L- 1 — i s c _ d 1TION add�I�IO N ----J UN ���`-__ : - I i 1 LFEHLT i r, i I �� �'ti—r —_d er i,✓ � f i Kivu 20:8 t KRic i!ti �n�nan Anl �e PLANNING& DEVELOPMENT i' ii; i F— Z � a p il I N W W • C� N t7 oZS - Rnil Z Z Cl- b0cl - ' --rJ I d I 0 N { C c c Ij I b G� .r^ 1 r� M n O A • v o W 0 _..:.....::.. .. .. .. .... . . ... .. .. i �d. � r 1 ey 1 C :� gr • IIj 1, i l \ µ\ 91 A I O cn n a Z � . z G) G� 40 < rn N m z �� I V L Z w ....r-.:. ...a .... ........... .... ..... �v:.a.-r r ..r...�..:a ... ....: .....r..v ... .....—....v..v..i ....v r:e...r ....._r..v r...._a.a..... ...a.. .ra :.a ....a.... vr. ..r. ... .....:.:.a.: .. e... ......v.r.v.... ..ar.v a.. .r ....... .. .. ... .... C=) J.. . N w o r lL C.D Q Z 1 Z Z 0 z V IQ 1 U � GJ a � h oo u° _ � J 'e •� u o b o � - Z V' 9 Oo J � bOvi v j � CIS V� b m 14 NO ZL DO W ` � � o Q k 1 f r a o- r v ss LOT 6 °`. ° �`° P� LOT 5 30,000 ± S.F. (0.60 + .4C) 99 Goy 110 sw Off, LOT 4 b JOB #93-023 CER TIFIED PLOT PLAN LOCATION : LOT 5 COVENTRY LANE WEST BARNSTABLE PREPARED FOR SCALE l - so REEF REALTY REFERENCE : PLAN BOOK 454 PAGE 96 I HEREBY CERTIFY THAT THE STRUCTURE ����O JO liHN v�� 9c SHOWN ON THIS PLAN IS LOCATED ON THE o 7_. yN GROUND AS SHOWN HEREON. DEMIAREST,JR. m No.36859 � Dail U � �Ess'•°;�e �t su,c� DEMAREST-McLELLAN ENGINEERING 24 SCHOOL STREET AUGUST 9. 1993. P.O. BOX 463 WEST DENNIS. MA DATE P E SIONAL LAND UVEYOR TOWN OF BARNSTABLE OLD IUNG'S HIGHWAY HISTORIC DISTRICT COMMITTEE STATEMENT OF UNDERSTANDING As property owner/contractor/agent.for the construction at: 110/004/006 52, Coventry Lane Map/Parcel Number Street West Barnstable Village Only minor changes may be approved by the Committee without a new application and a. hearing. Minor changes include things like moving:a single window or door or a minor change of color. All changes by amendment require the Committee's,written approval. A request for change must be submitted to the Committee in writing. Approval must be. obtained before incorporating the change into the project. For more than one revision to approved plans, a new application for a Certificate of Appropriateness must be applied for. Failure:to comply with approved plans may result in the Building Department issuing.a stop work order or denying an Occupancy Permit. I HAVE READ AND UNDERSTAND THE ABOVE STATEMENTS; August 29, 2018 Signed: Date Signed: Paul Richard,Chair,Old King's Highway 73i6IL0li\iG 0-PT SEP 18 2018 i OWN OF BARNS 1ABLE Town of Barnstable Old King's Highway Iiistoric District Committee DECISION Wednesday, August 29, 2018, 6;30pm The Barnstable Committee of the Old King's Highway Historic District Committee, acting in accordance with the Old.King's Highway Regional.Historic District Act, Chapter 470,Acts of 1973 as amended,has held a hearing and made determinations on the following applications: I APPLICATIONS—CONTINUED FROM AUGUST 8,2018 FVITUDR-A FVN-Margaret at Bursley Manor LLC,Rankin,Margaret,651 Main Street,West Barnstable,Map 156,Parcel 057,Bursley Homestead,Built 1827,Contributing Building in a National Register Historic District Replace 19 windows with Anderson 400 series,true divided lights,black ***Certiflcate gfAppropriateness►vithdraivit without prcjudice*''* Griffin,Deborah& Harry,3609 Main Street,Barnstable,Map 317,.Parcel 043/001 Install 18,all,black,flush mounted solar modules on the rear elevation ***Certiftcate of Appropriateness Approved as Submitted APPLICATIONS VanGelder,David,52 Coventry Lane,West Barnstable,Map 110,Parcel 004/006 Repaint home,shutters•,and trim *"Certificate of Appropriateness Approved as Submitted*"* Raggio,Anthony&My-Le,23 Point Hill.Road,West Barnstable,Map 136,Parcel 017 Landscape plan(new build was approved July 12,2017) *"Certificate of Appt•optirtteness Appi-oved us Submitted*'c* Teague,Christian,101 Braggs Lane,Barnstable,Map 299,Parcel 043/001 Change siding from Clapboard to White Cedar Shingles 11"Cettificrtte ofAppropriatenessApproved as Submitted"* Burbic,Brian,.137 Maushop Avenue,Barnstable,Map 278,Parcel 046/001 Install a 20'.X 40'pool and 18' X 14' Gazebo ***Certificate ofAppropriateness Approver/as Submitted l," - - . �-- S��^� _ -- d .. - o 0 ,ag _ c R � m I V v.a�.�= ��� � JUL 3. 1 2018 ME,� o Barnstable Old Kings Highway Historic District Committee 200 Main Street,Hyannis,MA 02601,Tel 508.862.4787 Eml erin.loa �MAM.z r�i ax MUM&WEVIa-UPMENT HAMg 2639. �e D tARt� APPLICATION, CERTIFICATE OF APPROPRIATENESS Application is hereby made,with five(5)complete sets,for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470,Acts and Resolves of Massachusetts, 1973,for proposed work as described below and on plans,drawings,or photographs accompanying this application for: Check all categories that apply; 1. Building construction: ❑ New ❑ Addition ❑ Alteration 2. Type of Building: ❑ House ❑ Garage/barn ❑ Shed ❑ Commercial ❑ Other 3. Exterior Painting roof ❑ new roof e@ color/material change,of trim,siding,window,door 4. Sign : ❑ New Sign ❑ Existing Sign ❑ Repainting Existing Sign 5. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Retaining wall ❑ Tennis court ❑ Other 6. Pool ❑ Swimming ❑ Other man-made pool ❑ Solar panels ❑ Other Type or Print Legibly: Date &i NOTE All applications must be signed by the current owner Owner(print): D.W L/I 0 4A 4 i� Telephone#: �� .� /C> Address of Proposed Work:--Q- �'G� %je�� Village gv►:ZZl�Map Lot# i' Mailing Address(if different) Owner's Signature Description of Proposed Work: Give particulars of work to be done: s Agent or Contractor(print): Telephone#: Address: Contractor/Agent'signature: For conini ttee use only This icate is hereby APPROVED / DENIED AP®®^ _/ ldicmbers signatures AUG 2 9.2018 Town of Barnstable Old Kings Highway Conditions of approval Committee PP 1 OAH?017 Cert App-oprialeness.doc NEW, Z ,; Legend ,,� [J Parcels ARAM an "Town Boundary 1 / �/ -` Railroad Tracks 160 #190 ! �'` 15 l #175 ©Buildings #209 1 r Painted Lines ` ! ' #10 1 j,/ Parking Lots ! c; #199 ~• � #5 I ": � i ❑ Paved `� f :[•'1 , Unpaved r r \ \ \ rr :.� f Driveways #174 L]Paved C r/ Unpaved #189 �� I J� �•� , /- r�` -� - •��. Roads #159 0 Paved Road , i• 0 Unpaved Road #183 r 1:::: ���~" 0 Bridge !, /I 3i 35 E Paved Median #163 \�:':.1 �� Streams #142 Marsh #173 � Q Water Bodies #52 fh #'0 Ze #10 #104 mot ti` aah: ;;.•.;"xkc`"':.: 1 `- uv 1109 #140• Map printed on: 8/16/2018 This map is for illustration purposes only.It is not Parcel lines shown on this map are only graphic Town of Barnstable GIS Unit adequate for legal boundary determination or representations of Assessor's tax parcels.They are Feet regulatory interpretation.This map does not represent not true property boundaries and do not represent 367 Main Street,Hyannis,MA o2601 O 167 333 an on-the-ground survey.It may be generalized,may not accurate relationships to physical objects on the map 508-862-4624 reflect current conditions,and may contain such as building locations. 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'. t_"�M � F r�'4••,. ,IV,}� �'{�.,'7� � ,. •>(' 4 5A'• p' L •Fi .lf�,+s,iwr +yt. �r i^•r• ��+��.. ...�w t� An 4 t;� 'j •+ to 1 - • ;:�� 9�.: - •4 wr' L. { -`:3`:. -+' i r'�"� ,+.,j-c, ,� .�. ��+w J a r. -[{@�'��' � •. .��. i ,a:. � ..ice` :- , •. .. + •1f�i .f .� �r`i —_ •;r4e C'- E • e...�� NY- �• �„ K er{� ` •+, ' rr„'. + ♦ r_.,+- 'iMllr t•: _ .c Yam. . �•,ta'r, ,RL• •rJ •-. : may \♦ .. t ,r, F_ •ti' /�1i nag MJ 1- "00, Ole, o � Roo/" C z � a� QN The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 IF www.mass.gov/dia Workers' Compensation Insurance Affidavit: Builders/Contractors/Electricians/Plumbers Applicant Information n / Please Print Legibly N&e(Business/Organization/Individual): �A &5eggs7" 307 X-V City/State/Zip: `����? / CE,yi¢0�VQPhone#: ,5_ &f Are you an employer?Check the appropriate fox: Type of project(required): 1.[1I am a employer with l--4' I am a general contractor and I 6. ❑New construction employees(full and/or part-time).* have hired the sub-contractors 2.❑ I am a sole proprietor or partner- listed on the attached sheet. 7. ❑Remodeling ship and have no employees These sub-contractors have g, ❑Demolition working for me in any capacity. employees and have workers' 9. 14 Building addition [No workers'Comp.insurance comp.insurance.t equired.] 5. ❑ We are a corporation and its 10.❑Electrical repairs or additions 3.N I am a homeowner doing all work officers have exercised their 11.❑Plumbing repairs or additions myself [No workers'comp. right of exemption per MGL 12.❑Roof repairs insurance required.]t c. 152,§1(4),and we have no employees. [No workers' 13.❑Other comp.insurance required.] *Any applicant that checks box#1 must also fill out the section below showing their workers'compensation policy information. t Homeowners who submit this affidavit indicating they are doing all work and then hire outside contractors must submit a new affidavit indicating such. =Contractors that check this box must attached an additional sheet showing the name of the sub-contractors and state whether or not those entities have employees. If the sub-contractors have employees,they must provide their workers'comp.policy number. 1 am an employer that is providing workers'compensation insurance for my employees. Below is the policy and job site information. Insurance Company Name: Policy#or Self-ins.Lic.#: Expiration Date: Job Site Address: City/State/Zip: Attach a copy of the workers'compensation policy declaration page(showing the policy number and expiration date). Failure to secure coverage as required under Section 25A of MGL c. 152 can lead to the imposition of criminal penalties of a fine up to$1,500.00 and/or one-year imprisonment,as well as civil penalties in the form of a STOP WORK ORDER and a fine of up to$250.00 a day against the violator. Be advised that a copy of this statement may be forwarded to the Office of Investigations of the DIA for insurance coverage verification. I do hereby certify under the a enalties of erjury that the information provided above is a and correct ^S� atures�' G79 Date: ' Phone#: Official use only. Do not write in this area,to be completed by city or town official City or Town: Permit/License# Issuing Authority(circle one): 1.Board of Health 2.Building Department 3.City/Town Clerk 4.Electrical Inspector 5.Plumbing Inspector 6.Other Contact Person: Phone#: I L Information and Instructions Massachusetts General Laws chapter 152 requires all employers to provide workers' compensation for their employees. Pursuant to this statute,an employee is defined as"...every person in the service of another under any contract of hire, express or implied,oral or written." An employer is defined as"an individual,partnership,association,corporation or other legal entity,or any two or more of the foregoing engaged in a joint enterprise,and including the legal representatives of a deceased employer,or the receiver or trustee of an individual,partnership,association or other legal entity,employing employees. However the owner of a dwelling house having not more than three apartments and who resides therein,or the occupant of the dwelling house of another who employs persons to do maintenance,construction or repair work on such dwelling house or on the grounds or building appurtenant thereto shall not because of such employment be deemed to be an employer." MGL chapter 152,§25C(6)also states that"every state or local licensing agency shall withhold the issuance or renewal of a license'or permit to operate a business or to construct buildings in the commonwealth for any applicant who has not produced acceptable evidence of compliance with the insurance coverage required." Additionally,MGL chapter 152, §25C(7)states"Neither the commonwealth nor any of its political subdivisions shall enter into any contract for the performance of public-work until acceptable evidence of compliance with the insurance requirements of this chapter have been presented to the contracting authority." Applicants Please fill out the workers' compensation affidavit completely,by checking the boxes that apply to your situation and,if necessary,supply sub-contractors)name(s),address(es)and phone number(s)along with their certificate(s)of insurance. Limited Liability Companies(LLC)or Limited Liability Partnerships(LLP)with no employees other than the members or partners,are not required to carry workers' compensation insurance. If an LLC or LLP does have employees,a policy is required. Be advised that this affidavit may be submitted to the Department of Industrial Accidents for confirmation of insurance coverage. Also be sure to sign and date the affidavit. The affidavit should be returned to the city or town that the application for the permit or license is being requested,not the Department of Industrial Accidents. Should you have any questions regarding the law or if you are required to obtain a workers' compensation policy,please call the Department at the number listed below. Self-insured companies should enter their self-insurance license number on the appropriate line. City or Town Officials Please be sure that the affidavit is complete and printed legibly. The Department has provided a space at the bottom of the affidavit for you to fill out in the event the Office of Investigations has to contact you regarding the applicant. Please be sure to fill in the permit/license number which will be used as a reference number. In addition,an applicant that must submit multiple permit/license applications in any given year,need only submit one affidavit indicating current policy information(if necessary)and under"Job Site Address"the applicant should write"all locations in (city or town)."A copy of the affidavit that has been officially stamped or marked by the city or town may be provided to the applicant as proof that a valid affidavit is on file for future permits or licenses. A new affidavit must be filled out each year.Where a home owner or citizen is obtaining a license or permit not related to any business or commercial venture (i.e.a dog license or permit to burn leaves etc.)said person is NOT required to complete this affidavit. The Office of Investigations would like to thank you in advance for your cooperation and should you have any questions, please do not hesitate to give us a call. The Department's address,telephone and fax number: The Commonwealth of Massachusetts Department of Industrial Accidents Office of Investigations 600 Washington Street Boston,MA 02111 Tel.#617-727-4900 ext 406 or 1-877-MASSAFE Revised 4-24-07 Fax#617-727w7749 www.mass.gov/dia QUITCLAIM DEED Joyce Layne, an unmarried person, of 52 Coventry Lane, West Barnstable, MA 02668 For consideration paid and in full consideration of FOUR HUNDRED THIRTY-FIVE THOUSAND AND NO ONE HUNDREDTHS ($435,000.00) DOLLARS Grants to David R. Van Gelder,Jr. and Kristin E. Cohan, as joint tenants, of 6 Julia Grace Lane, Harwich, MA 02645 with QUITCLAIM COVENANTS The land in Barnstable(West), BARNSTABLE COUNTY, MASSACHUSETTS,together with the buildings thereon, further bounded and described as follows: LOT 5 PLAN BOOK 454 PAGE 96 LOT 5 as shown on a plan of land entitled`Bodfish Farms II Definitive Open Space Development Plan in West Barnstable, MA dated April 10, 1988 by Doyle Engineering Associates, Inc., and recorded with the Barnstable County Registry of Deeds in Plan Book 454, Page 96. Said premises are conveyed subject to and with the benefit of any and all rights, rights of way, easements,reservations,restrictions or other conditions of record insofar as the same may be in force and applicable. The Grantor hereby releases all rights of Homestead in the subject property. The street address of the property is. 52 Coventry Lane, West Barnstable, MA 02668 For title see Deed recorded in Book 22574 Page 341. MASSACHUSETTS STATE EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date: 04-09-2018 a 03:06am Ct14: 150E Doc4: 16222 Fee: $IY487.70 COns: $435►000.00 BARNSTABLE COUNTY EXCISE TAX BARNSTABLE COUNTY REGISTRY OF DEEDS Date2 04-09-2018 8 03:06am Gtl': 1508 Doc': 16222 Fee. $1,331.10 Cons: $435,000.00 t; I r : 1 tise u� 1 2 cn Q413I HL3a D a zo�'on vv3o a .-CCL7 Nsi oom a98i D o. o 0 -eNam Scri;; 's' aa - n3gO 'sas 3tl g; i O n g; dp� s. Oo l n D $ �08= »S'K a3n 5'a " E 1. na o �n 'J6�n a°3o ° .. AF n-gs vn gaBo ooN a 8" Agag 93 n o 38i= °-�EO�. -10 3 n 0183 . g$ � � NN °cSs o 0 €m€ g mgE �\o"3 8=^s a os =ao' a MUM 8g81 � 3� AINg g 1;.3 ' G S� E 6� It R HUM C. o G g . gnp > c= O o gE F Iz m-fio OD 2 a OI�w>� O ✓n9 q.SmGI �2 � ZyA mp ; o-�� C BT S � A�I 2§Y p mgOk �mO u so� �1y.I CFF pp m5 o 'F 5�-�Zpo Oup otippSpd'mC�Yl �OOo2 p nZpnl p, p m;o o Or m 8x .0 ypm■ Q p 0' QQANmmp N �CC I N *>pO,F zoa FCiPL1 z z o� o -A ' 'z �m 6a N dim mDmFFFziiin=z x� y2L1� zQ pc 11p2„6 A. To j�a pm LFF LI m^iQ ��LS M� Ip fp tm pS <D CSC O Om Zqz mp m7yCr� m N F�sm m v � imp€ 9s M ai OAn -0vooa pzoN pp ��mop In'p Fi �W�y Fy z� nail p '. ;o oAapo N g i o 02 2.2m 4 ;-,y IA cc�,umzi p ^> s-.^g Rs $gz o0 my ozi l 1 � L� Fin F� @�CjQ o 6c ac mp C lBLBy" Lm" F RZ� �A Oay� Za G B SS F P p0 C- HC�- 0 yym f ^ U 10i . ouzi 63 3 i��z oo i• 3z of 4` _ gg ..9 L $° �0 `z'g �a F 4" € igpp gym$ �m 01 �_�'$ �_ _� 5-A'.a3 {! 6m 0a Om=N O C �N Q mo z z m "ao 15 A � LL pp y�^7� my a 01F s ul Tr �y -+pi loci �Ao o OpZy 2,QSQ � 4pocmac"•c O o 'ap �F F�oSF y1y m2>n9inow,fm'1O 0 46-OC �Z9 Tml� OmZ� RCp AI'y� pQ 2�p6 G p'.n0Z=nI=4A r0 0 Ca "O op .Lr!� ~� �� n z� x*- ��� Q F Z o � Fno Z FF t "p NN�<yZm3u omo �g� ON 1. ��mZ<mN2 y1a O yc : `9' CIO O n CI�� ni $ o zQm@Omii2 Cin cp uzi n>mm u9 FO °v '3'.'gVic AAA' 'oT t A r c flit .S - CS' LL r Co., V a nA L�2rJ '$ �'i y l•�yl� c DATE: 10/4/18 ADDITION TO BACK OF HOME TH IT O THE INTENT OF THESE DOCUMENTS TO DWG: NO. SCALE: 1/4"=1' KRISTIN COHAN & JOHN SPINK, P.E. PROVIDE CEDSUF BUILDENTER INFORMATION TO THE EXPERIENCED BUILDER TO CONSTRUCT THE DAVID VAN GELDER DESIGNS PROJECT SHOWN. IT IS THEREFORE HIS RESPONSIBILITY TO VERIFY ACCURACY AND & Q WIND BRACING COMPLIANCE WITH ALL REGULATORY AGENCIES r52 COVENTRY LANE—,' 59 CLAY STREET, MIDDLEBORO, MA 02346 PRIOR TO CONSTRUCTION. THEIR REQUIRE- MENTS MUST TAKE PRECEDENCE OVER THOSE SHOWN, AND FIELD ADJUSTMENTS MADE r 0 avrmcer c m 7 as soae ACCORDINGLY. rL �- �— _r I I k k k Ia I :, � , � 1-�-�..r �-i_i��-�__i -►-, . � �r • �r-!_fig-�_ ��r� �j r��l���F.► II.�k�rF- ► I N , ib-1 I � A 90 eb IJ a n Z I •� rj � bo I-' — I I � ! a 2 o o a F ! s� p cn o'- J o ! 1 . 0� 3 Q Ian Cry.- m � Y I z - nl J �' --- ---- ---- _ — — — -- — liz C [n O - to 1 S- !�\ ell � � n 743 71 .O ' r7 1 ! ! Icj L 77 OQ . 0 I 4 , e _ z c ~ l / iC s I I. 1, fff ;i a 'i r !4 1p el 91 A • F I I • ti I w p o c — c c q q 1 >t 0\ W� ............. .......... ............ ...... +a I- - r o, -� x� cn `• CA � n ON i U PO o V 1 O� 00 n oq 1 1 50 u C oq o O A 1 r2-- ic- 09 JT p Q , M ' h (� q- o O �, 2 a i v, ss o° �, °0. LOT 6 �° °' a� LOT 5 30,000 ± S.F. (0.69 ± aC.) 9y gyp. "•`\o�•A 110. LOT 4 JOB #93-023 CER TIFIED PL 0 T PL A N LOCATION : LOT 5 COVENTRY LANE WEST BARNSTABLE PREPARED FOR SCALE : / - - so REEF REALTY REFERENCE : PLAN BOOK 454 PAGE 96 OF I HEREBY CERTIFY THAT THE STRUCTURE ����\\AOHNASsgo SHOWN ON THIS PLAN IS LOCATED ON THE o Z. tiN GROUND AS SHOWN HEREON. a DEMAREST,JR. 0 No.36859 Z J DEMAREST-McLELLAN ENGINEERING - �Na sum° 24 SCHOOL STREET AUGUST 9, 1993, P.O. BOX 463 WEST DENNIS, MA DATE P 0FE SIONAL LAND UVEYOR . ' .� Town of Barnstable Building M� ; JPost This Card So That it is Visible From the Street-Approved Plans Must be Retained'on Job and this Card Must be Kept b'¢ `� IPosteBAIRUNK d�Until Final Inspection Has Been Made.1 jWhere a Certificate of Occupancy is Required,such Building shall Not be Occupied until a Final Inspection has been made. Permit Permit No. B-18-1397 Applicant Name: LAYNE,JOYCE Approvals Date Issued: 05/08/2018 Current Use: Structure Permit Type: Building-Siding/Windows/Roof/Doors Expiration Date: 11/08/2018 Foundation: Location: 52 COVENTRY LANE,WEST BARNSTABLE w Map/Lot: 110-004-006 Zoning District: RF Sheathing: Owner on Record: LAYNE,JOYCE I Contractor Name:` Framing: 1 Address: 6 JULIA GRACE LANE Contractor License: 2 HARWICH, MA 02645 - Est. Project Cost: $13,000.00 Chimney: Permit Fee: 66.30 Description: re-roof stripping old shingles,reside&replace 26 windows 3 doors $ .27 uvalue Fee Paid: $66.30 Insulation: Project Review Req: t3 Date: 5/8/2018 Final: r: r �� Plumbing/Gas ~ ` Rough Plumbing: _ ,i\Building Official Final Plumbing: This permit shall be deemed abandoned and invalid unless the work authorized by this permit is commenced within six months afterlssuance. All work authorized by this permit shall conform to the approved application and the"approved construction documents for which this permit has been granted. Rough Gas: All construction,alterations and changes of use of any building and structures shall be in compliance with the local zoning by-laws and codes. This permit shall be displayed in a location clearly visible from access street or road and shall be maintained open for public inspection for the entire duration of the Final Gas: work until the completion of the same. i F Electrical The Certificate of Occupancy will not be issued until all applicable signatures by the Building and Fire Officials are provided on this permit. Minimum of Five Call Inspections Required for All Construction Work: f +` Service: 1.Foundation or Footing 2.Sheathing Inspection ,- — Rough: 3.All Fireplaces must be inspected at the throat level before firest flue lining is installed 4.Wiring&Plumbing Inspections to be completed prior to Frame Inspection Final: 5.Prior to Covering Structural Members(Frame Inspection) Low Voltage Rough: 6.Insulation 7.Final Inspection before Occupancy Low Voltage Final: Where applicable,separate permits are required for Electrical,Plumbing,and Mechanical Installations. Health Work shall not proceed until the Inspector has approved the various stages of construction. Final: "Persons contracting with unregistered contractors do not have access to the guaranty fund" (as set forth in MGL c.142A). Building plans are to be available on site Fire Department All Permit Cards are the property of the APPLICANT-ISSUED RECIPIENT Final: �I Town of Barnstable *Permit '! Y-'/J � Tres 6 months from issue date Building Departmedrop wee anaxsr�t.F Brian Florence,CBp ��4 `� i639� 9 M"�' Building Commissioner !. �0 �f0 MA't 200 Main Street,Hyannis,MA 02601 �1q y 0 www.town.barnstable.ma0N/A ?®�� Office: 508-862-4038 ��� Fax- 508-790-6230 EXPRESS PERAUT APPLICATION - RESIDENTIAL O& Not Valid without Red X-Press Imprint Map/parcel Number JJ 2 onerti+Address 0�i��r7u(7�� G�✓ lil/� � SI� IG��i�<'� 02 Residential 4W — Minimum fee of$35.00 for work under$6000.00 Owners Name Contractor's Name Telephone Number Home Improvement Contractor License#(if applicable) Email: Construction Supervisor's License#(if applicable) ❑Workman's Compensation Insurance heck 0 ❑ I am a sole proprietor I am the Homeowner ❑ I have Worker's Compensation Insurance Insurance Company NameP��c Workman's Comp.Policy# Copy of Insurance Compliance Certificate must accompany each permit. t3Request.(c eck'bux> Re-roof(hurricane nailed)(stripping old shingles) All construction debris will be taken to ❑Re-roof(hurricane nailed)(not stripping. Going over existing layers of roof) Re-side Replacement Windows/doors/sliders.U-Value o 07 (maximum.32)#of windo #of doors: *Where required: Issuance of this permit does not exempt compliance with other town department regulations,i.e.Historic,Conservation,etc. ***Note: Property Owner must sign Property Owner Letter of Permission. A copy of the Home Improvement Contractors License&Construction Supervisors License is required. SIG.0 UR*F_ QAWPFILESTORMSTXPRESS2017 The Commoirweakh of Massaclrusetts Dputmait oflirdw&ialAccid-m& Office offnve agafions 600 WashfiVton Street Boston,MA 02111 mPt-v mas&gov1dxa Workers' CampensafiunIusu ance Affidavit$nilders(CnntractursMecEricianslPlumhers APPF=nt Infoirmafi>an f Please Print f -biY • �, - � ��S �L� Pam' ��-S�i��71� Are y*ou an emplayer?Check the appropriate ba= ' T of project r 1.❑ I am a 1 wrth 4. ❑I am a general contrsctar and I Yl� P 7 { egnn-ed}: 6- ❑New 000stroiaa employees(fa11 or part-lime)* have lxired9m sub-ca�at-t xs 2.❑ I am a sale proprietor orparbier- listed enthe attached sheet. ?- ❑Remodeling ship and have no-employees These sab-comtractars have lt_-❑Demolition wod:ing forme is any capacity_ employees and have worms' 9. ❑Suild"mg adzi&— [No{vows'comp.insm= a coaup.msarauml reqaire -] 5. ❑ We are a cogwrafien and its M❑Electrical repairs or additions (- ,K I am a bomecamer doing all work officers have exercised their 1L❑Flumbingrepaiss or adfEfiaas myself MM [No workers'�F c f�of ouer - 11 52,§1{ dwehs�veao ❑Hoofrep-airs . insurance required-]1 employees.[No wosl=* 13.❑other conp_sasoxz=required-] 'Any appKczat&st c1edmbaa 91 mast dui ffiotathe se �i cdmbeIowag dwkwndae compeasatitru ia�poEcyiumL I Enmemnem who subn t&ds af5dara iaEcatiag{Ley aS dttin�ag wmit and Hten bite aatside ca�scta[s�st submit s new ai5da4it iadicatit�sar7i ICoattsctoa that r'hWY fhi bmt mast attadu�an atidititmal sheet sbuuiiig the aanee of Q�e sub-can xs�d state whe15� not Phase a tiesha� employees.Ifthesnh-can=ctabmmnp yea;fty—stPzuvid•dm7w Wadcae COMP.PGRUM—ber: I ant an erlipiay�r flint;is prauidir�g workers'coarpertsrtiiar�irrsrrrarrce for rr�y empFoj�ees: $efoav is fJ�e pa8cy ardd je8 sda inforrnatiom Insurance companyName: 'Policy 4 or Self-ims_Lic-¢ ExpiraticaDDate: Job Site Address: Cify/StatE04p: Attach a copy of the worliere coaupensationpolicy-dedara4ion page(showing the porky number and expiration{Tate). Faftre to secare coverage as requiredu der Section 25A of MOL a 152 can lead to the imposition of criminal penalties of a fine up to$L50QOa andlor one-year imprisonment,as well as civ2 penalties m the form of a STOP WORK ORDER and a fine of up to$250-04 a dap against the violator.-Be advised that a copy of this statema t.may.be forwarded to the Office of Invest gatioms of the DIA for insmmce coverage vedficatim I'do hereby comfy red penahies o.fF�1l1�$iat8re irrforma#ivrtprovtrt�d abo��a is hue and correct 7� OB&id use only. Do not write in dds"ea,€a be canT&esd by cite arfoivn of`ieiat City or Town: Permifllicense Issuing Auffioritg(curie one): L Board of Health I BusTding Department 3.aiyirown Qerk 4.Electrical Inspector S.Plmmbiag Inspector 6.Other Contact Person: Phoim#- - — - - - 6 orma.tion and lastrueflons � � MM&�1 setts Ganeaal Laws chapter M requires all egployehs'to pravide wows'com.Peas'- ion fur their MVIayees_ pursuant-W this ,an=Tk yw is defined as.":every peason in the seavice of another under any contract ofhire, express or implied,oral or wri t rnf An emproyer is defroed as"air mcpividnal,partnership,assoc�oaf coipoh�ian or other legal entity,or any two or more of the Rxegoing=gaged in aJoint ,and including the legal repieseAativm cf a deceased employe",c r the receiver or trustee of an individnaL partu=mhhp,association or other Iegal entity,employing employers. However the owner of a dwelling house baying not more than three apaxfinenis and Who resides therein„or the occupant ofthe - dwaMng house of another Who employs persons to do maintenance,construction.or repair walk on such dweIling house or on.the grounds or building app iheaeto shallnotbecanse ofsach employmenfbe deemedto be an employer." MGL chapter 152,§25C(6)also st Ed=that"every state or local Reensing agency shall withhold the issuance or renewal of a license or permit to operate a budmess or to construct bindings ia.th.e commonwealth for any applicantwho has not produced acceptable evidence of compUanm with the insurance.coverage required" A(i tonally,MCrL chapter 152, §25C(7)stars"Neither the c rrrm mweahh nor any ofits political subdivisions shah enter into any contra amza ct for the pm am 0fpablic wok utoI ac ce ptable eve vide of compliance w in with the s urance. requirements of this chapt m bave been presented to the contracting aothoizty." A pphcaats Please fiEa out the wo,3=1 compensatiou affidavit completely;by cog the boxes that apply to your situation and,if necessalL Supply scl ohs)name(s), (es)ancl phone numbers)along w&their cerifficab*)of ��ce. Lmnted Liab�y Companies(LLC)or Limited IaabUity Partue. p s(I LP)with no employees oilier.than the members or partners,are not required to cagy wm iceas'campensafraa insurzam If an LLC or LLP does have employees,a policy is required. B e advised that this affidayrt may be so mith--d to the Department of Indust-W Accidents for confamation of mswx ce coverage Also be sure to sign and date the affidavit. The affidavit should be-retmmed to the city or inwn that the application for the peonit or license is being regnest A not the Department of . LnAastad A ca den s. Mumld you have any questions regarding the Iaw or ifyou are regohed to obtam a work=' compensation policy,Please call the Departm eot at the i mmIer listed below. Self-i onrd.companies should enter their self-i sarance license uumnher an the appropriate line. City or Town.Ofacials Please be sure that the afdavit is complete and printed.Iegiib y. Ihe Department has provided a space at the:bottom of the affidavit for you to fill out in the event tine Office of Iuvestiogfions has to contact you regarg the applicant_ Please be sure to fill in the peamL t cense mmnber which will be used as a retorenco nronber. Iu addition,an aPPl?cant that must submit muHiple permit/Iicrose applications in any gives year,need only submit one affidavit indi,caimg cnrreat policy information(if neces:say)and under`Tub Site Address"the applicarlt should v ntr-"all locations in (citY ar town):'A copy of the-affidavit that has been officially stamped or madced by the city or town may be provided to the applicant as proofthat a valid affidavit is on file for fafare pezIIu�or licenses Anew affidavit must be filled out each year.Whem a home owner or cities is obtaining a license or permit not related D any business or commercial venture (Le. a dog license or permit to bum leaves etc.)said person is NOT required to complete this affidavit The Office of Investigations Would like to thank you in advanco for your coopendion and should you have any questions, please do not hcsifate to give us a cal The Departments address,telephone and fax�mbea: The COMMMWI-ld*Of MkSWCb-M S&CM ' Depaitamt cif 1iid Accidents ' �4�ashmgF�n S`tc�xt -Ta 617-' -4900 ext 406 Qr 1-977 MA SSAM Fax 617 727 7749 Revised 424-07 ww rnas59PVIffa A VE Town of.Barnstable Building Department * &ARNSr"LFi ' Brian Florence,CBO v�A s. 163 .�� Building Commissioner ren a 200 Main Street,Hyannis,MA 02601 www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 Property Owner Must Complete and Sign This.Section If Using A Builder I ,as Owner of the subject property hereby authorize to act on my behalf in all matters relative to work authorized by this building permit application for: (Address of Job) **Pool fences and alarms are the responsibility of the applicant Pools are not to be filled or utilized before fence is installed and all final inspections are performed and accepted. Signature of Owner Signature of Applicant Print Name Print Name Date QTORM&OWNERPERMLSSIONPOOLS Rev:10/17 'Town of Barnstable r z oFtMe rq,�, Building Department Brian Florence CBO • Building Commissioner MMSTALEIM MASS. $ 200 Main Street, Hyannis,MA 02601 AtF1 M 6 p www.town.barnstable.ma.us Office: 508-862-4038 Fax: 508-790-6230 HOMEQWNER LICENSE EXEMPTION /R �� Please Print number s4reet village name home phone# work phone# I' C'��v l`kaff -ADDRESS: �� cityttown state zip code The current exemption for"homeowners"was extended to include owner-occupied dwellings of six units or less and to allow homeowners to engage an individual for hire who does not possess a license,provided that the owner acts as supervisor. DEFINITION OF HOMEOWNER Person(s)who owns a parcel of land on which he/she resides or intends to reside,on which there is,or is intended to be,a one or two-family dwelling,attached or detached structures accessory to such use and/or farm structures. A person who constructs more than one home in a two-year period shall not be considered a homeowner. Such "homeowner"shall submit to the Building Official on a form acceptable to the Building Official,that he/she shall be responsible for all such work performed under the building permit. (Section 109.1.1) The undersigned"homeowner"assumes responsibility for compliance with the State Building Code and other applicable codes,bylaws,rules and regulations. The undersigned"homeowner"certifies that he/she understands the Town of Barnstable Building Department minimum inspection•procedures and requirements and that be/she will comply with said procedures and r nts r Si- eofHomeowner Approval of Building Official Note: Three-family dwellings containing 35,000 cubic feet or larger will be required to comply with the State Building Code Section 127.0 Construction Control HOMEOWNER'S EXEMPTION The Code states that: "Any homeowner performing work for which a building permit is.required shall be exempt from the provisions of this section(Section 109.1.1-Licensing of construction Supervisors); provided that if the homeowner engages a person(s)for hire to do such work,that such Homeowner shall act as supervisor." Many homeowners who use this exemption are unaware that they are assuming the responsibilities of a supervisor(see Appendix Q,Rules&Regulations for Licensing Construction Supervisors,Section 2.15) This lack of awareness often results in serious problems,particularly when the homeowner hires unlicensed persons. In this case,our Board cannot proceed against the unlicensed person as it would with a licensed Supervisor. The homeowner acting as Supervisor is ultimately responsible. To ensure that the homeowner is fully aware of his/her responsibilities,many communities require, as part of the permit application,that the homeowner certify that he/she understands the responsibilities of a Supervisor. On the last page of this issue is a form currently used by several towns. You may care to amend and adopt such a form/certification for use in your community. . ! Assed,5or'�office .(lst floor): c I SEPTIC SYSTEM�(/�• bI TM E TO Assessor's map and lot number ..... ...�..�...lJO...!... INSTALLED Board of Health (3rd floor): �d ..... IN COM Sewage Permit, number ! �". ......... . WM y ... ... f MU Z B6Sd9Il1DLL. i Engineering Department (3rd floor). oZ ��% ENVIRONMENTAL COO "�°q. House number ...... ................................................................. - TOWN REGUL ATIO czar 6�e Definitive Plan Approved by Planning Board ____'t k__� _____./_�-_19_s `. APPLICATIONS PROCESSED 8:30-9:30 A.M. and 1:00 2 0 P.M. only` APPPOVED TOWN OF BARNSTABLE `Iti1>lt8ble Conservation Do"U I L D I N G_ * INSPECTOR PPLICATIONFORDOWIT TO ...... tLt.lh�........................................................................................................ TYPE OF CONSTRUCTION ...0 ........... .1.................19...... TO THE INSPECTOR OF BUILDINGS: The undersigned hereby applies for a permit according to to the following information: .�Location .�r ..- . aI�il -�'.... 1`?6.....i......W F��T.... .��.NST..{- .� ....................:........................ 7 , ProposedUse ...... .............................................................................................................................. Zoning District ......... .......i.............................................Fire District ..... (L�1 .t�� -C Name of Owner P'T:M I�-..?....... ?. .......................Address O t 8(o S d Name of-Builder v.E .... ..!.+JC�I.t.J. :.............Address ...I..`Q.:.R4 �.. �.- th?.N.l :�.1✓1. ... � Nameof Architect ............ .....— ...............................Address ...................................... .--............................... Number of Rooms ......... ..........:..........................................Foundation I.Q?tQ. .�c?! !? f)^i.....-'..... ...................... I�?.. Exterior../ .. .... . ................................................Roofing Floors 9��j ...C1itJC.. 1�(DO .....................................Interior .l.L��...5? -D...1'J/SE.'a l .!- !� .... .Ic k � Heating `:....!1-. ,►z�b.....�.N�`................ �.1.�.o �C:aw...7Lk Plumbing 11J Fireplace .. .2.!4_- ..L47r v.. L4. ...................................Approximate Cost .......`1`j.1.Gc5o.:"L.. ���!//�7 Area �./�.`�.,►!v.�..S F:....:. Diagram of Lot.and Building with Dimensions Fee !7 `V\ OCCUPANCY PERMITS REQUIRED FOR NEW DWELLINGS I hereby agree to conform to all the Rules and Regulations of the own o Barnstable regarding the above construction. / ' / Name . c.�L. ••.............. ............... Construction Supervisor's License ...03. .......l................ Y , AMEK HOLDINGS - =r Permit for ..TWO.1"'; TORY Single Family Dwel ling -� >:. . { Lot #5, 5 2? Co entry Lane •tSocation ......................................... West Barnstab]�e - r - ... .. .o. ..................... = V r Owner ..:'Amek-Holding.. .......... r ! _ T• ,� r `, .. .. .:.. Type o Constructiotn - ..:. Fra .e ...... .. .. s � _ ........ ' Plot ...c.�... . ..:........... Lot'-- `° ... ........ PermitjGran+ed •rAugus,t 17.,. '19 93 l y - L f t - ^. Date`o nspec ion����.........9`..0�.!,�9 L Date Completed ...: �� 19 i C-3-a - o � ti a tf n _ � N 0 I IL im °E 0 e NY a x u 3 ms �4z F - 4ii • 3 y 'I Y I 2r} J_ I�•I � .I CIS � •'I ,�' - cow S l2 . � O yt r 4 i r st "c z r<r tl I ' I i I i ! r . N N ' N J N c ' p ' N I J �I e +. O lV ilT L!> „: u s� � 1 %I } a R I IQ TO I I_I��lal91-'til-I it I J u 9� I IJ J J� 9;JJ N (� yim�A'J:N- Nltui z 1_ Ni Q � s i Z e fig I a g�i, O I I rvLLAB� } ull BSI — 1I;L ,t i _I � a g a N In o t J Q• L 2 i �L� X �0 4 yT .�l � ir lie `9 2VIf r r 7 N � ;LL N rN• 1(�R'ONr A i`i' qqt J---g b IL • 6TJ 1 ((( � r 7 N f N N N I 0 Imo°/ ��P ► Is I �� �' iekti a I N AID N o ` � � o i �19Z i i i _ f Fit U ►- 0 p Sd 11• Y z'e.b 11aNn oIL y 33a �d rn3 doaa ��J e 0 dti, ' m awo-dod A ?� d e«o god do�a dre CL • r--—-t-—— — I Id i r pl �,I 1 3 1i I v I e PVI . P I £ + �o F I b r —:TO I; Ll i + N r E 3 y �� i►s•dya 1 Naine Arlek Holdings of Cape Cod Address Lot 5 Cav _ntry Lane OLD KING'S HIGHWAY REGIONAL West Barnstable HISTORIC DISTRICT COMMITTEE SPEC SHEET FOUNDATION: Poured concrete SIDING TYPE: White cedar clear shingles COLOR: -Natural Red cedar .clapboards Cliffside Gray CHIMNEY: Kelsey Ferguson Mohawk New brick COLOR: Red ROOF MATERIAL: Asphalt shingles PITCH: COLOR: Weathered-Wood 147INDOWS: RIVCO double hung w/snap out grilles SIZE• 12/12 TRIM COLOR: White DOORS: 4 lite paneled steel COLOR: Heritage Blue SHUTTERS: `� Vinyl` COLOR: Heritage Blue GUTTERS: 'Seamless Aluminum COLOR: White DECK: pressure treated wood SIZE: 20x10 COLOR: Natural GARAGE DOORS,:-Paneled masonite~�� COLOR: Cliffside gray STORM WINDOWS & DOORS: Aluminum COLOR: White SKYLIGHTS: SIZE: (FLAT ONLY APPROVED) OUTDOOR LIGHTING: TYPE (SHO-W WHERE) NUMBER & WATTAGE: (FLOOD LIGHTS NOT APPROVED FOR FRONT OF HOMES IN RESIDENTIAL AREAS) NOTE: GROUND SIGNS 'MUST BE 'ATLEAST 51 ..'INSIDE APPLICANT'S 'PROPERTY LINE. ***METAL BUILDINGS NOT APPROVED IN NON-INDUSTRIAL/COMMERCIAL AREAS*** I I THREE COPIES OF THIS FORM MUST BE SUBMITTED ALONG WITH THE APPLICATION. FILL OUT COMPLETELY REGARDING MATERIALS, MEASUREMENTS & COLORS . ELECTRIC METER LOCATION: Side of hose a Q � WE 4S I �3oI Fj� D LANDSCAPING: 1,00 square feet of sod, 8 shrubs, barkmulch to cover all disturbed areas �3(as3 a Application to Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTIFICATE OF APPROPRIATENESS `. Application is hereby made, iri triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts, 1973, for proposed work as described below and on plans, drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ® New Building . ❑ Addition ❑ Alteration Indicate type of building: ® House ® Garage ❑ Commercial ❑ Other 2. Exterior Painting: 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other'side for explanation and requirements). TYPE OR PRINT LEGIBLY GATE , May" 3, 1993 ADDRESS OF PROPOSED WORK Lot 5 Coventry Lane, W. Barnstable ASSESSORS MAP NO. 110 OWNER AMEK Holdings of Cage Cod, Inc. ASSESSORS LOT NO. 4-6 HOME ADDRESS .P.O. Box 186,= W. Dennis, MA 02670 TEL. NO. -194-3090 FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). AMEK Holdings of Cane Cod Inc.`- P O Box 186 West Dennis. MA 02670 Jeremiah Bradbury Entr Inc - P.O.'--Box 841 Barnstable MA 02630 Rra i n,t� ropp prat i ve Rank — 1010 Waah i nqt on St Rra i nt rap-, MA 091 84 AGENT OR CONTRACTOR FhrAratt W_ EJ=r- Jr lRctw-f Raalay 1,31H TEL. NO. 394-4090 ADDRESS P.O. Box 186 West Dennis, MA '02670 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No.8,other side),including materials to be used, if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed locations of new signs. (Attach additional sheet,if necessary). 50' x 26' three bedroom colonial style new dwelling with hip roof, two car drive- under garage, 20' x.:10' pressure treated wood deck, and red brick chimney. Signed* Owner-Contractor-A t ! Space below Ime for Committee use. Received by H.D.C. e ificate i rebyJ Date Cc D � T TOWN OF BARNST IMPORTANT: If Certificate Is approved,approval is subject to the 10 day appeal period provided in the Act. k1C5�S� Disapproved 0 i i i ADDITIONAL INFORMATION FOR MAKING AND FILING AN APPLICATION FOR A CERTIFICATE OF APPROPRIATENESS The four categories for which a Certificate'of Appropriateness is required are: (application'for demolition or removal is a separate form).. . 1. EXTERIOR BUILDING CONSTRUCTION (new or existing buildings): An application is required for any exterior of a building to be erected or altered.including windows, doors, siding,-roof, light etc., that will be visible from any public street, way or public place. The following scale drawings are required in duplicate with application: plot plan (if addition = show existing buildings in outline), floor plan and elevations. Also required are snap shots of existing buildings, where additions or alterations are to be made. No plot plan is required for addition or alteration which does not touch the ground. 2. EXTERIOR PAINTING: An application is required for any portion of a building, structure or sign to be painted that is visible from a public street, way or public place. Color samples must be attached.to these applications. An application is not required when repainting existing colors, changing to white,or using colors approved by the Town Historic District Committee. 3. SIGNS OR BILLBOARDS: An application is required for any sign or billboard to be erected within the District, with the following exceptions: _ a. Existing signs or billboards on November 27, 1974 shall have until November 27, 1977 to secure an approved Certificate of Appropriateness. b. Temporary signs for use in connection with any official celebration or parade or any charitable drive as long as they are removed within three days of the event. Certain other temporary signs that the Committee feels does not detract from the Act may be allowed with the prior permission of the Committee. c. Real Estate signs of not more than 3 square feet in area advertising the sale or rental of the premises on which they are erected or displayed. d. A single sign of not more than 1 square foot in area showing the name, occupation or address of the occupant of the premises on which they are erected or displayed in a residential Zone. 4. STRUCTURE: An application Is required to build or alter any structure within the District which is defined by the Act as a combination of materials other than a building, sign or billboard, but including stone walls, flagpoles,hedges,gates, fences, etc. GENERAL REQUIREMENTS 5. Work on projects requiring approval shall not be started until the Certificate of Appropriateness has been filed with the Town Clerk by the Committee. Approval is subject to the 10day appeal period provided in the Act. 6. No changes shall be made from the original approved specifications without advance approval of the Commission on an amended application filed with the Committee. 7. A separate application must be filed with each project requiring a Certificate of Appropriateness. 8. Under heading of "Detailed,Description of Proposed Work" give detailed data on such architectural features as: foundation, chimney, siding, roofing, roof pitch, sash and doors, window and door frames, trim, gutters —leaders, roofing and paint color. 9. Unless application is complete and legible and all material required is supplied,application will not be accepted.or,acted upon: �rl, Copies of the Act establishing the Regional Historic District may be obtained at theTown=Hall _ -- ' 441:r,a �.�. : '•� . Y a. ' COMMONWEALTH DEPARTMENT OF PUBLIC SAFETY OF ONE ASHBORTON PLACE Cs.de iL cC,.rc for rcvocsfiop ��� BOSTON,MA 02108 MASSACHUSETTS CAUTION LICENSE ' EXPIRATION DATE CONSTR. SUPERVISOR FOR PROTECTION AGAINST UT RIGHT THUMB EFFECTIVE DATE LIC-NO. THEFT, P �3/11/199 6 PRINT IN APPROPRIATE R STRICTIONS 06/30/1993 032809 o BOX ON LICENSE D . NONE 5 o E IV ER E TT A BOY J R � BLASTING OPERATORS Z WODENNIS MA 02b70 Z MUST INCLUDE PHOTO. ; m SS Al 033-42-4928 m PAID PHOTO,(BIASTING OPR ONLY) FEE: 0.O0 NOT VALID UNTIL SIGNED BY LICENSEE AND OFFICIALLY . r/ '�` �.] • APED-OR-SIGNATURE OF THE COMMISSIONER HEIGHT: 9 1993 JUN . Doe: ' ' 0 3/11 /19 S 4 W SIGN NAME IN FULL ABOVE SIGNATURE LINE .. `5 `�,� IGNATURE OF LICENSEE D • f J�r 1ti1� 1t THIS DOCUMENT MUST BE //�/+�`__ Ifs �si o CARRIED ON THE PERSON OF ISSIONER THE HOLDER WHEN EN- ° f � ds`2w�HtcIA�PNI GAGEDINTHISOCCUPATION. 1 •I i - •:; Application to 'moo Old Kings Highway Regional Historic District Committee in the Town of Barnstable for a CERTI FICATE OF APPROPRIATENESS . Application is hereby made, id triplicate, for the issuance of a Certificate of Appropriateness under Section 6 of Chapter 470, Acts and Resolves of Massachusetts. 1973. for proposed work as described below and on plans. drawings or photographs accompanying this application for: CHECK CATEGORIES THAT APPLY: 1. Exterior Building Construction: ® New Building ❑ Addition ❑ Alteration Indicate type of building: ® House ® Garage ❑ Commercial ❑ Other 2 Exterior Painting: 3. Signs or Billboards: ❑ New sign ❑ Existing sign ❑ Repainting existing sign 4. Structure: ❑ Fence ❑ Wall ❑ Flagpole ❑ Other (Please read other side for explanation and requirements). TYPE OR PRINT LEGIBLY DATE May 3, .1993 ADDRESS OF PROPOSED WORK Lot 5 Coventry Lane, W. Barnstable ASSESSORS MAP NO.—110 OWNER AMEK Holdings of Cane Cod, Inc. ASSESSORS LOT NO. 4-6 HOME ADDRESS P-0. Box 186_ W. Dennis- 19, 0 670 TEL NO. 124-1ngn FULL NAMES AND ADDRESSES OF ABUTTING OWNERS. Include name of adjacent property owners across any public street or way. (Attach additional sheet if necessary). AMEK Holdings of Cate Cod. Inc. - P O Box 186 West shis- MA 02670 -Jememiah Bradbury Entr. . Inc. - P.O. -Box 841 Barns able MA 02630 Ara i nt rpp- C'nnMrat i yA Rank — 101 n Wa ch i n at nn Rt Rra i nt rwFa- Mn n 7 1 Rd AGENT OR CONTRACTOR ramratt W t sr- .Tr lRPw:& Malty rV_ TEL NO, zCIA-anon ADDRESS - P.O. Box 186_ WestDr�nnis MA A 670 DETAILED DESCRIPTION OF PROPOSED WORK: Give all particulars of work to be done(see No.S.other side),including materials to be used. if specifications do not accompany plans. In the case of signs,give locations of existing signs and proposed locations of new signs. (Attach additional sheet.if necessary). 50' x 261 three bedroom colonial style new dwelling with hip roof,. two car drive- under garage, 20' x.101 pressure treated wood deck, and red brick chimney. � D `1l}«J� U ` lr� � _ �l Signed � Jowever-ContraCtoir-Agerr Soeee below line for Committee use. Rec ived bv H.D.C. De Certificate' reby / I T e 'OWN F BARNSTAgI$ viN�• HI ppro Ay MPORTANT: If Cartlffeats Is approved,approval Is subject to the 10 day appeal period_/ provided in the Act. .�`/ y,� Disapproved ❑ 1 - ` *Tame AcnP_}c Holdings of Cape Cod Address Lot Coventry na OLD KING'S HIGHWAY REGIONAL West Barnstable HISTORIC DISTRICT COMMITTEE Cliffside Grav i SPEC SHEET I FOUNDATION: Poured concrete i Herit,i�c 131uc -- I SIDING TYPE: White cedar clear shingles COLOR• .Natural Red cedar clapboards Cliffside Gray CHIMNEY: Kelsey Ferguson Mohawk New brick COLOR• Red ROOF MATERIAL: Asphalt shingles PITCH': COLOR: Weathered-Wood WINDOWS: RIVCO double hung w/snap out grilles SIZE: 12/12 TRIM COLOR: White DOORS: 4 lite paneled steel COLOR: Heritage Blue SHUTTERS : Vinyl COLOR: Heritage Blue GUTTERS: Seamless Aluminum COLOR: White DECK: Pressure treated wood SIZE: 20X10 COLOR: Natural GARAGE DOORS: Paneled masonite COLOR: Cliffside gray STORM WINDOWS & DOORS: Aluminum COLOR: White SKYLIGHTS: (FLAT ONLY APPROVED) J11 1I'Lri ��.'JI '� C;� -lc L l t l ;� OUTDOOR LIGHTING: TYPE (SHOW WHERE) NUMBER & WATTAGE: (FLOOD LIGHTS NOT APPROVED FOR FRONT OF HOMES IN RESIDENTIAL AREAS) NOTE: - GROUND SIGNS 'MUST BE AT 'LEAST 51 .INSIDE APPLICANT'S PROPERTY LINE. ***METAL BUILDINGS NOT APPROVED IN NON-INDUSTRIAL/COMMERCIAL AREAS*** THREE COPIES OF THIS FORM MUST BE SUBMITTED ALONG WITH THE APPLICATION. FILL OUT COMPLETELY REGARDING MATERIALS, MEASUREMENTS & COLORS . ELECTRIC METER LOCATION: Side of hoBse LANDSCAPING: 1,00 square feet of sod, 8 shrubs, barkmu_lch to cover all disturbed areas IT�1��9 (`� �,�� �" 'i,1:. .:ft..r .� �' !ur. :.. a.1is�.. I�es 6t;•;�3�a���i�.,11° (1} ��S�al�al . .., .�� es c4+.•��a � DATE nt.z� co APPLICANT C.Vyi: i- 45C: vr ADDRESS 11 (NO.) (STREET) ICONTR•S,LICENS PERMIT TO 11�-sCi (_) STORY ,:'�;;;;y: ;-Ai,� DWELLING UNITS NUMBER OF • (TYPE OF IMPROVEMENT) NO• U ` (PROPOSED SE) .�aJL --J �[: C0v__i: '�'.; ;i1 1. .''J i,21•.A::.:i i_r.i l,:y ZONING AT (LOCATION) DISTRICT (N0.) `(STREET)'+ BETWEEN AND (CROSS STREET) (CROSS STREET) LOT SUBDIVISION LOT BLOCK SIZE BUILDING IS TO BE FT. WIDE BY FT. LONG BY FT. IN HEIGHT AND SHALL CONFORM IN CONSTRUCTION TO TYPE USE GROUP BASEMENT WALLS OR FOUNDATION (, (TYPE) REMARKS: ;.�a; ,i.s..tt.] .93-334 AREA OR VOLUME �:y -. (; t�'<, i..:... 9 G t;ti. %V PERMIT ESTIMATED COST (CUBIC/SQUARE FEET) OWNER ADDRESS •V" i / c::: _ ...- BUILDING DEPT. BY _ i'�'. �:'.. �' Yam`r• !. THIS PERMIT CONVEYS NO RIGHT TO OCCUPY ANY STREET, ALLEY OR SIDEWALK OR ANY PART THEREOF, EITHER TEMPORARILY OR PERMANENTLY. ENCROACHMENTS ON PUBLIC PROPERTY, NOT SPECIFICALLY PERMITTED UNDER THE BUILDING CODE, MUST BE AP- PROVED BY THE JURISDICTION. STREET OR ALLEY GRADES AS WELL AS DEPTH AND LOCATION OF PUBLIC SEWERS MAY BE OBTAINED FROM THE DEPARTMENT OF PUBLIC WORKS. THE ISSUANCE OF THIS PERMIT DOES NOT RELEASE THE APPLICANT FROM THE CONDITIONS OF ANY APPLICABLE SUBDIVISION RESTRICTIONS. MINIMUM OF THREE CALL APPROVED PLANS MUST BE RETAINED ON JOB AND THIS WHERE APPLICABLE SEPARATE INSPECTIONS REQUIRED FOR PERMITS ARE REQUIRED FOR CARD KEPT POSTED UNTIL FINAL INSPECTION HAS BEEN ALL CONSTRUCTION WORK: ELECTRICAL, PLUMBING AND I. FOUNDATIONS OR FOOTINGS. MADE. WHERE A CERTIFICATE OF OCCUPANCY IS RE- MECHANICAL INSTALLATIONS. 2. PRIOR TO COVERING STRUCTURAL QUIRED,SUCH BUILDING SHALL NOT BE OCCUPIED UNTIL MINAL INSPECTION TI TO BEFORE FINAL INSPECTION HAS BEEN MADE, 3. FINAL INSPECTION BEFORE OCCUPANCY. POST THIS CARD SO IT IS VISIBLE FROM STREET BUILDING Jh(SOCTIOP A RO_ , PLUMBING INSPECTION APPROVALS ELECTRICAL INSPECTION APPROVALS -INN- � \rXf a 3 I i i HEATING INSPECTION APPROVALS �E_N�GII�I DER G DEEF AARRTTM�ENT O l) C BOARD OF HEALTH OTHER SITE PLAN REVIEW APPROVAL WO HA NOT PROCEED UNTIL THE INSPEC• ' PERMIT W!L L BECOME NULL AND VOID IF CONSTRUCTION INSPECTIONS INDICATED ON THIS CARD CAN BE TOR HAS APPROVED THE VARIODUS STAGES OF WORK IS NOT STARTED WITHIN SIX MONTHS OF DATE THE ARRANGED FOR BY TELEPHONE OR WRITTEN CONSTRUCTION. I PERMIT IS ISSUED AS NOTED ABOVE. NOTIFICATION. I - O,YMI TOWN OF BARNSTABLE Permit No. .......... ...�. BUILDING DEPARTMENT ""n I Cash TOWN OFFICE BUILDING M� V HYANNIS.MASS.02601 Bond ................ CERTIFICATE OF USE AND OCCUPANCY Issued to AMEK HOLDINGS Address lot #5 52 Coventry Lane, West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WIT14 TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. October 21 93 19................. .. ...... ...................... Bui ding Inspector * � TOWN OF BARNSTABLE permit No. ....... �� BUILDING DEPARTMENT TOWN OFFICE BUILDING Cash Yl x 'era,..► HYANNIS.MASS.02601 Bond CERTIFICATE OF USE AND OCCUPANCY Issued to AMEK HOLDINGS + Address lot #5 52 Coventry Lane, West Barnstable USE GROUP FIRE GRADING OCCUPANCY LOAD THIS PERMIT WILL NOT BE VALID. AND THE BUILDING SHALL NOT BE OCCUPIED UNTIL SIGNED BY THE BUILDING INSPECTOR UPON SATISFACTORY COMPLIANCE WITH TOWN REQUIREMENTS AND IN ACCORDANCE WITH SECTION 119.0 OF THE MASSACHUSETTS STATE BUILDING CODE. October 21 93 '�Gty 19................. ........ ...... ........................ Building Inspector v TOWN OF. BARNSTABLE 'BUILDING DEPARTMENT TOWN OFFICE BUILDING rua HYANNIS, MASS. 02601 cur MEMO TO: Town Clerk FROM: Building Department DATE: ✓D�/ 93 An Occupancy Permit has been issued for the building- authorized by BuildingPermit $ .._�._`�_ �Do7 ............................................... ...................................... �...... �....�__ issuedto .........../.� � ,14 -_............... .............._...._...._.... ... .......__.� _ _ __ . Please release the performance bond.